Volume monitoring systems

ABSTRACT

An apparatus has a syringe housing. A plunger has a shaft, wherein the plunger is slidably received within the syringe housing between a first and second position. A Hall sensor is disposed within the shaft and a magnet is fixed proximate the syringe housing.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims priority to and the benefit of U.S. PatentApplication Ser. No. 62/141,723, filed Apr. 1, 2015, entitled “VolumeMonitoring Device Utilizing Hall Sensors”. This application is also acontinuation-in-part of U.S. patent application Ser. No. 14/222,331,filed Mar. 21, 2014, entitled “Volume Monitoring Device Utilizing LightBased Systems”; which is a continuation-in-part of U.S. patentapplication Ser. No. 13/975,052, filed Aug. 23, 2013, entitled “VolumeMonitoring Device”; which is a continuation-in-part of U.S. patentapplication Ser. No. 13/839,771, filed Mar. 15, 2013, entitled “Devicesand Methods for Modulating Medium Delivery”; which claims priority toand the benefit of U.S. Provisional Application Ser. No. 61/694,137,filed Aug. 28, 2012, entitled “Devices and Methods for Modulating MediumDelivery.” This application is also a continuation-in-part of U.S.patent application Ser. No. 14/851,958, filed Sep. 11, 2015, entitled“Reservoir for Collection and Reuse of Diverted Medium”; which claimspriority to and the benefit of U.S. Provisional Application Ser. No.62/082,260, filed Nov. 20, 2014, entitled “Devices and Methods forModulating Medium Delivery”; and U.S. Provisional Application Ser. No.62/048,974, filed Sep. 11, 2014, entitled “Devices and Method forModulating Medium Delivery.” The disclosures of each of theseapplications are hereby incorporated by reference herein in theirentireties.

INTRODUCTION

This disclosure pertains to systems, devices, and methods used tocontrol, transform or otherwise modulate the delivery of a substance,such as radiopaque contrast, to a delivery site and/or systems, devices,and methods that may be used to measure or otherwise make quantitativeassessments of a medium delivered to a delivery site. More specifically,it is the intention of the following systems, devices, and methods tomodulate and/or assess the delivery of media to a vessel, vascular bed,organ, and/or other corporeal structures so as optimize the delivery ofmedia to the intended site, while reducing inadvertent or excessiveintroduction of the media to other vessels, vascular beds, organs,and/or other structures, including systemic introduction.

The terms medium (media), agent, substance, material, medicament, andthe like, are used generically herein to describe a variety of fluidalmaterials that may include, at least in part, a substance used in theperformance of a diagnostic, therapeutic or/and prophylactic medicalprocedure and such use is not intended to be limiting.

SUMMARY

This summary is provided to introduce a selection of concepts in asimplified form that are further described below in the DetailedDescription. This summary is not intended to identify key features oressential features of the claimed subject matter, is not intended todescribe each disclosed embodiment or every implementation of theclaimed subject matter, and is not intended to be used as an aid indetermining the scope of the claimed subject matter. Many other noveladvantages, features, and relationships will become apparent as thisdescription proceeds. The figures and the description that follow moreparticularly exemplify illustrative embodiments.

In one aspect, the technology relates to an apparatus having: a syringehousing; a plunger having a shaft, wherein the plunger is slidablyreceived within the syringe housing between a first position and asecond position; at least one Hall sensor disposed within the shaft; andat least one magnet fixed proximate the syringe housing. In anembodiment, the magnet includes a plurality of magnets disposed aboutthe syringe housing. In another embodiment, a magnet retention ring isdisposed about the syringe housing, wherein the plurality of magnets aredisposed within the magnet retention ring. In yet another embodiment,the Hall sensor includes a plurality of Hall sensors. In still anotherembodiment, the shaft defines an interior chamber and the plurality ofHall sensors are disposed linearly within the chamber.

In another embodiment of the above aspect, a wireless transmitter isdisposed within the chamber. In an embodiment, the apparatus further hasa circuit board, wherein the plurality of Hall sensors are disposed onthe circuit board; a battery is disposed on the circuit board, whereinthe battery is configured to provide power to at least one of theplurality of Hall sensors; and a switch is disposed on the circuit boardfor selectively connecting power between the battery and the at leastone of the plurality of Hall sensors. In another embodiment, the switchis activated based on a movement of the plunger.

In another aspect, the technology relates to an apparatus having: asyringe housing defining an axis; a plunger slidably disposed along theaxis within the syringe housing; a plurality of Hall sensors disposedalong the plunger; at least one magnet fixed relative to the axis, suchthat a movement of the plunger along the axis moves at least one of theplurality of Hall sensors through a magnetic field created by the atleast one magnet. In an embodiment, the at least one magnet includes aplurality of magnets disposed about the axis, so as to create asubstantially circular magnetic field. In another embodiment, theapparatus further has a magnet retention ring disposed about the syringehousing and wherein the plurality of magnets are disposed within themagnet retention ring. In yet another embodiment, a wireless transmitteris disposed within the plunger. In still another embodiment, a batteryis disposed within the plunger, wherein the battery is configured toprovide power to the wireless transmitter and at least one of theplurality of Hall sensors; and a switch disposed within the plunger forselectively connecting power between the battery and the wirelesstransmitter and at least one of the plurality of Hall sensors.

In another embodiment of the above aspect, the switch is activated basedon a movement of the plunger. In an embodiment, the switch includes areed switch. In another embodiment, the plunger is configured forrotational movement about the axis, and wherein the at least one of theplurality of Hall sensors is disposed so as to pass through the magneticfield at any angular position of the plunger about the axis. In yetanother embodiment, the magnet retention ring is disposed proximate aproximal end of the syringe housing. In still another embodiment, themagnet is secured directly to the syringe housing.

In another aspect, the technology relates to a method of determining acondition of a syringe having a syringe housing and a plunger slidablydisposed in the syringe housing, the method including receiving a firstsignal from a first Hall sensor, wherein a position of the first Hallsensor on the plunger is known. In an embodiment, method furtherincludes determining a second position of the plunger based at least inpart on a received second signal.

Further, in another aspect, the technology relates to a system formodulating a fluid being delivered to a patient and the ability tomeasure the amount delivered. A myriad of ways of measuring a volume ina chamber, and the subsequent amount of medium injected to a site in apatient, are described. Further, the ability to modulate the delivery ofa medium to a patient is exemplarily described. The modulation in oneaspect may include diversion of a portion of medium being injected by asyringe (or the like). An aspect of the technology relates tomeasurement of a total amount of medium ejected from a syringe/chamber,while measuring an amount of medium diverted away from the patient intoa “diversion” reservoir, so as to determine the actual volume deliveredto an intended site in the patient.

In another aspect, the technology relates to a method of determining anamount of medium injected into a patient, the method including:receiving an injection signal from a sensor associated with an injectionsyringe; receiving a diversion signal from a sensor associated with adiversion reservoir; and determining the amount of medium injected basedat least in part on the injection signal and the diversion signal. In anembodiment, the method includes sending a signal associated with theamount of medium injected. In another embodiment, the method includesdisplaying the amount of medium injected. In yet another embodiment, themethod includes receiving a flush signal associated with a valve of asaline flush system. In still another embodiment, the method includesdisregarding at least one of the injection signal and the diversionsignal based at least in part on the flush signal. In anotherembodiment, the method includes adjusting a position of at least onevalve based at least in part on the flush signal.

BRIEF DESCRIPTION OF THE DRAWINGS

There are shown in the drawings, embodiments which are presentlypreferred, it being understood, however, that the technology is notlimited to the precise arrangements and instrumentalities shown.

FIG. 1A depicts an exemplary synchronized agent delivery with indirectmodulation, adjacent a distal portion of a treatment system therefor.

FIG. 1B depicts a top view of an exemplary synchronized agent deliverywith indirect modulation, adjacent a proximal portion of such atreatment system.

FIG. 1C depicts a side view of an exemplary synchronized agent deliverywith indirect modulation, adjacent a proximal portion of such atreatment system.

FIG. 1D depicts a side sectional view of the brake mechanism of theexemplary synchronized agent delivery arrangement of FIG. 1C.

FIG. 2 depicts a perspective view of an embodiment of a monitoringsyringe.

FIG. 3 depicts a partially exploded perspective view of the monitoringsyringe of FIG. 2.

FIGS. 4A-4C depict partial enlarged perspective views of otherembodiments of monitoring syringes.

FIGS. 5A-5C depict embodiments of a monitoring syringe.

FIG. 6 depicts a partially exploded perspective view of anotherembodiment of a monitoring syringe.

FIG. 7A depicts a first method of using a monitoring device.

FIG. 7B depicts a second method of using a monitoring device.

FIG. 8 depicts one example of a suitable operating environment in whichone or more of the present examples may be implemented.

FIG. 9 depicts a perspective view of a first embodiment of a monitoringsyringe utilizing a Hall sensor module.

FIG. 10 depicts a partial perspective sectional view of the monitoringsyringe of FIG. 9, depicting the Hall sensor module.

FIG. 11 depicts a partial exploded perspective view of the monitoringsyringe of FIG. 10.

FIG. 12 depicts a partial perspective view of a Hall sensor module.

FIG. 13 depicts a perspective view of a second embodiment of amonitoring syringe utilizing a Hall sensor module.

FIG. 14 illustrates an exemplary medium management system.

FIG. 15A is a perspective view of another example of a medium diversionreservoir.

FIG. 15B is a perspective exploded view of the medium diversionreservoir of FIG. 15A.

FIG. 15C is a cross-sectional view of the exemplary medium diversionreservoir in a first configuration, taken along line 15C-15C of FIG.15A.

FIG. 15D is a cross-sectional view of the exemplary medium diversionreservoir in a second configuration, taken along line 15C-15C of FIG.15A.

FIG. 16 illustrates another exemplary medium diversion reservoir.

FIG. 17 illustrates another exemplary medium management system.

FIG. 18 depicts a method of determining an amount of medium injectedinto a patient.

DETAILED DESCRIPTION

There are numerous occasions in the diagnostic, prophylactic andtreatment practice of medicine wherein an agent, medicant, or medium ispreferably delivered to a specific site within the body, as opposed to amore general, systemic introduction. One such exemplary occasion is thedelivery of contrast media to coronary vasculature in the diagnosis(i.e., angiography) and treatment (i.e., balloon angioplasty andstenting) of coronary vascular disease. The description, as well as thedevices and methods described herein, may be used in modulating and/ormonitoring medium delivery to the coronary vasculature in prevention oftoxic systemic effects of such an agent. One skilled in the art,however, would recognize that there are many other applications whereinthe controlled delivery and/or quantitative assessment of a media to aspecific vessel, structure, organ or site of the body may also benefitfrom the devices and methods disclosed herein. For simplicity, thesedevices and methods may be described as they relate to contrast mediadelivery modulation and/or measurement. As such, they may be used in theprevention of Contrast Induced Nephropathy; however, it is not intended,nor should it be construed, so as to limit the use to this sole purpose.Exemplary other uses may include the delivery, injection, modulation, ormeasurement of: cancer treatment agent to a tumor, thrombolytic to anoccluded artery, occluding or sclerosing agent to a vascularmalformation or diseased tissue; genetic agent to a muscular bed, neuralcavity or organ, emulsion to the eye, bulking agent to musculatureand/or sphincter, imaging agent to the lymphatic system, antibiotics toan infected tissue, supplements in the dialysis of the kidney, to namebut a few.

Example—Prevention of Contrast Induced Nephropathy

Contrast Induced Nephropathy (CIN) is a form of kidney damage caused bythe toxic effects of dyes (radiopaque contrast media) used, for example,by cardiologists to image the heart and its blood vessels duringcommonly performed heart procedures, such as angiography, angioplasty,and stenting. In general, the dye is toxic and is known to damagekidneys. Although most healthy patients tolerate some amount of the“toxicity,” patients with poorly or non-functioning kidneys may sufferfrom rapidly declining health, poor quality of life, and significantlyshortened life expectancy. Potential consequences of CIN include:irreversible damage to the kidneys, longer hospital stays, increasedrisk of heart disease, increased risk of long-term dialysis, andultimately, a higher mortality risk. For patients who acquire CIN, theirrisk of dying remains higher than others without CIN, and this risk cancontinue up to five years after their procedure. CIN has a significanteconomic burden on the healthcare system and currently there is notreatment available to reverse damage to the kidneys or improper kidneyperformance, once a patient develops CIN.

To date, there have been attempts in reducing the toxic effects ofcontrast media on patients who undergo procedures involving dyes,especially those patients who are at high risk for developing CIN. Someof these efforts have been to: change the inherent toxicity (of achemical or molecular nature) of the dyes, reduce the total amount ofcontrast agent injected (through injection management and/or dyeconcentration), and remove media through coronary vasculature isolationand blood/contrast agent collection systems, to name a few. Thesemethods and devices used in the control of the toxic effects of contrastagents have had their inherent compromises in effectively delivering acontrast media specifically to a target site while minimizing thesystemic effects. As an example, changing the composition of a dyeand/or injection concentration may help reduce a contrast agent'sinherent toxicity at the expense of the contrast agent's ability toperform its intended function (e.g., visualization of vasculature).Conversely, the ability to “collect” contrast agent laden blood“downstream” from the visualization site may ensure visualization, butrequires the complexity of placement and operation of a collectionsystem.

Other attempts to manage the amount of contrast agent delivered to apatient have employed automated, powered (versus manual,syringe-injected) contrast media injection systems. Close monitoring andcontrol of the total quantity of contrast agent injected may have apositive impact in reducing the incidence of CIN. However, theseinjection systems are expensive (including capital equipment anddisposables), cumbersome to use within a cath lab, and take additionaltime and expertise to set up and operate properly. Improper use couldnegate any benefits seen by better management of the quantity of thecontrast agent delivered to a patient, and the additional time requiredto set up such a system may also add significant complexity to aprocedure. The devices and methods described herein may measure orotherwise quantitatively assess the amount of medium injected ordelivered to a delivery site using a relatively fast, simple,economical, and safe system.

The measurement systems described herein may be employed as a system ofquantitative assessment or in combination with a modulator. Additionalsystems are described in U.S. patent application Ser. No. 13/839,771,the disclosure of which is hereby incorporated by reference herein inits entirety. FIGS. 1A-1D depict embodiments where a modulator isconstructed so as to measure the amount of an agent delivered from thesystem. Conversely, FIG. 2, for example, describes the use of ameasurement system for the quantitative assessment of the volume ofmedium delivered and the inherent analysis of the total volume deliveredversus some predetermined critical amount, such as the Gurm ratio,whether or not it is used with a modulator.

It should be understood that measurements may be performed prior to amedium being modulated, simultaneously with modulation, or after themodulation process, if desired. Further, it is also contemplated thatthe measurement devices and methods may be used with any of themodulation systems, such as described in U.S. patent application Ser.No. 13/839,771. Moreover, the embodiments described herein are exemplaryin nature and should not be construed as limiting the variouscombinations possible.

Some embodiments of control and modulation devices disclosed herein maysend and/or receive a sensor signal so as to coordinate a valving,controlling, or otherwise modulating function on an injection agentbefore the agent enters an intended target injection site. Modulationmay include, for example, valving (or otherwise modulating) an injectiondispensed from an injection device. As described in U.S. patentapplication Ser. No. 13/839,771, indirect valving (or otherwisecontrolling mechanisms) may be proximally or distally positioned within,about, and/or upon the agent delivery system. An example of an indirectmodulation control system 10 is depicted in FIGS. 1A-1D. In thisexample, a sensor 12 is deployed distally on a delivery catheter 14 (asseen in FIG. 1A) and a modulating device 30 (of FIG. 1B) is providedproximally. The sensor 12 of FIG. 1A is an exemplary pressure sensorpositioned on the distal tip of the delivery catheter 14. As describedpreviously, this is only one example of a type of sensor that may beused in obtaining a signal to synchronize the delivery of medium withthe blood flow rate. Moreover, FIG. 1A illustrates the positioning ofthe sensor 12 upon the distal tip of the delivery catheter 14 within theaorta 16 to the left coronary artery 18, off the aortic root 20. Theexemplary positioning of the sensor 12 in FIG. 1A should not be limitedto that shown in order to perform the functions described herein, sincethere may be a multitude of sensor types (and commensurate signals)positioned at various locations on (i.e., as a function of respiration),through (i.e., as a function of imaging) and within the body (i.e., as afunction of a variable proximate a target delivery site). Clearly, eventhe placement of a distal pressure sensor in exemplary FIG. 1A couldtake many forms, such as: a pressure wire alongside the catheter, alumen within the catheter body for pressure measurement, a pressuresensor deployed within the distal tip of the catheter, and a pressuresensor deployed distally of the distal tip of the catheter and into thetarget vessel, to name but a few.

Referring to FIG. 1B, modulating device 30 may include an inlet port 32(from the injection device) and an outlet port 34 (to the deliverycatheter 14). The flow of injection fluid may pass through the injectionport 32 and into a fluid chamber 36 within a body or housing 38 of themodulator 30. The modulator 30 may have a plurality of vane/plates 40attached to a cylindrical hub 42 disposed within the fluid chamber 36.The vanes 40 and hub 42 may be formed to define a “pinwheel” structureof vane-hub that is capable of rotating freely (relative to fluidchamber 36 and body 38 of modulator 30) upon the injection of mediuminto the fluid chamber 36 through the injection port 32. The hub 42 maybe designed to preferentially rotate in one direction. For example, FIG.1B illustrates the preferential flow of fluid and rotation of thevane-hub, in a clockwise direction, via flow arrows 44. From the fluidchamber 36, injection fluid may flow out of the modulator 30 via theoutlet port 34.

One advantage of the vane-hub modulator 30 depicted in FIG. 1B is thatit may be easy to measure, or otherwise identify, the total volume ofinjection fluid delivered through the modulating device 30 (over time)since the volume of fluid passing through the device 30 during onerotation of the vane 40 or hub 42 may be easily determined, and thenumber of rotations simply counted by a counting mechanism.Alternatively, each “cell” of fluid between adjacent vanes 40 may bereadily counted by a counting mechanism. The counting mechanism mayinclude a magnetic, mechanical, ultrasonic, infrared or similarmeasurement device capable of identifying the number of times a vane 40and/or some other element of the device 30 has passed within its fieldof measurement, or by determining the number of times the axis of thehub 42 has rotated. The output of such a counting mechanism may beutilized to determine and display (in real time) the total volume ofmedium used during a procedure. Advantageously, in the management ofmedium injected, an operator or physician may readily see the amount ofmedium used (as determined by the counting mechanism and presented by asuitable display or indicative output). The determination of the volume(via calculations or conversions based on, for example, countedrotations) may be performed as part of the counting device, or may beperformed by a display device. In addition to providing volumemeasurements, the counting mechanism, signal, or display may incorporatevarious algorithms to alert the operator before or when maximum volumeof agent has been administered (based upon an operator-determined value,Maximum Acceptable Contrast Dose, Gurm ratio, etc.). For example, theMaximum Acceptable Contrast Dose index, as described by Cigarroa, et al.(June 1989) “Dosing of Contrast Material to Prevent Nephropathy inPatients with Renal Disease” Am Jour of Med. 649-652, suggests that amaximum amount of contrast injected (in mL) be equal to 5 ml×body weight(Kg)/Baseline Serum Creatinine level (in mg/dL). In another example, themaximum amount of contrast injected (in mL) as described in Gurm, et al.“Renal Function-Based Dosing to Define Safe Limits of RadiographicContrast Media in Patients Undergoing Percutaneous CoronaryInterventions” JACC 2011:58:907-14, suggests that the maximum contrastused (in mL) should be less than, or equal to, 2 if it is divided by acalculated Creatinine Clearance (mL/min) of the patient. Regardless ofthe indicator utilized, the system may include a display that not onlyprovides total volume used, but also warns the operator of use ascompared to one or more indicators of a maximum administration.

Continuing with the description of the exemplary modulation device 30shown in FIGS. 1B-1C, the vane-hub modulator 30 may include twocomponents. The first, the body 38 (described above) may be situatedadjacent a controller/actuator 46 and may include the input port 32, theoutput port 34 and the fluid chamber 36 with rotating vane 40 and hub42. The body 38 may come into contact with bodily fluids and,accordingly, may be disposable. The controller/actuator 46 may alsoinclude a brake mechanism 48, sensor signal, receiver 50, and the likemay be used to clutch, brake, or otherwise inhibit the rotation of thehub 42 so as to provide resistance to rotation. The resistance inducedto the rotation may be coordinated with a signal from sensor 12 of FIG.1A, so as to modulate an injection from an injector to improve an agentfluid flow.

The braking, or clutching, of the modulator 30 of FIG. 1C may beperformed through a variety of mechanisms, to include, for example,mechanical, hydromechanical, electromechanical, electromagnetic,chemomechanical, etc. FIG. 1C illustrates one such mechanism 48 forbraking a shaft 52 of the hub 42, using electromagnetic force. Theexemplary braking structure 48 is further detailed in FIG. 1D, whereinthe longitudinal shaft 52 of the hub 42 is coupled to a hysteresis plateor disc 54 positioned within a magnetic coil 56. When electricity isapplied to the magnetic coil 56, a magnetic flux is transferred to thehysteresis disc 54 (as it passes through the field) causing a magnetic“drag” on the disc 54. The drag, or braking, applied to the hysteresisdisc 54 (and thus the shaft 52 of the hub 42) may be increased ordecreased with increasing or decreasing voltage applied to the magneticfield to modulate the flow of medium as intended. When electricalcurrent is removed, the connected disc 54 may rotate freely about anaxis of shaft 52. Upon modulating, braking mechanism 48 of FIG. 1D mayincrease the drag (reduce the flow rate) of the agent as needed toimprove the flow profile of the agent or fluid.

FIGS. 1A-AD describe one system to regulate the flow profile anddetermine the volume of injection agent through a modulator, and assuch, are intended to illustrate the modulation monitoring, control, andmeasurement concepts disclosed herein without limitation. Therefore,this embodiment is but one example how one might use a modulator deviceand a measurement device to control the delivery of an agent, as well asmeasure the amount of agent delivered.

Other embodiments including devices and methods in quantitativeassessment, or otherwise measurement, of the volume of delivery of anagent are described below. It is to be understood that these measurementdevices may also be used in combination with a variety of agentmodulators and the description is intended to be exemplary and notlimiting.

FIGS. 2 and 3 depict a perspective view and a perspective exploded view,respectively, of a monitoring syringe 100. The monitoring syringe 100includes a syringe housing 102 (or chamber) defining an inner bore 104.A plunger 106 including a shaft 108 and a piston 110 is slidablyreceived in the bore 104. More specifically, the piston 110 is slidablyengaged with an interior surface of the bore 104 and linear movement Mof the shaft 108 within the bore 104 moves the piston 110. Movement M isalong the syringe axis A_(S). The plunger 106 is moved back and forthwithin the bore 104 by the movement of a thumb pad, such as a thumb-ring112, as described in more detail below. As the plunger 106 is moved M ina direction towards the discharge end 114 of the syringe housing 102,the fluid contained therein is discharged into a tube or needle (notshown) and delivered to a patient. Note that throughout the descriptiona cylindrical-type chamber 102 and inner bore 104 are described;however, it is contemplated that there may be a variety of constructionsof a housing/bore 102/104 and plunger 106 that provide the function asanticipated herein and the shape (including rectangular, ovular,triangular cross-section, etc.), in and of itself, should not belimiting.

In the depicted embodiment, a light sensor module 118 is secured to anexterior surface of the syringe housing 102. The light sensor module 118includes a light sensor housing 119 that encloses a light sensor 120. Incertain embodiments, the light sensor 120 may be a linear arraycomprising a plurality of pixels, such as model no. TSL1406Rmanufactured by AMS-TAOS USA, Inc., of Plano, Tex. In other embodiments,the light sensor 120 may be one or more discrete light sensors, such asphotoresistors. In general, a greater number of discrete light sensorelements (pixels, photoresistors, or otherwise), may improve accuracy.One or more leads or wires 124 extend from an end of the light sensormodule 118, as required or desired for a particular application.However, one skilled in the art would readily recognize that wires 124need not be utilized with different sensor configurations. For example,using a light sensor on a circuit board may require alternativeconnections. A cable 126 connects at an end 128 to an interface unitthat analyzes the output of the light sensor module 118 and providesthis information to a user of the monitoring syringe 100, typically on adisplay. In other embodiments, communication may be via a radio,Bluetooth, of other wireless connection. The displayed information mayinclude volume of the chamber, volume remaining, volume dispensed, fluidtype, flow rate, fluid pressure or temperature and/or other information,as required or desired for a particular application.

In the depicted embodiment, the shaft 108 of the plunger 106 issubstantially translucent, meaning light may generally pass through theshaft 108. A discrete portion or band 130 may be disposed on or formedwith the shaft 108. The band 130, in this case, is a portion of theshaft 108 having a translucency less than the translucency of theremainder of shaft 108, or an opacity greater than the opacity of theremainder of the shaft. As the plunger 106 is slidingly moved M alongthe axis A_(s), the band 130 of lesser transparency passes in front ofthe light sensor 120 of the light sensor element 118. Light passesthrough the plunger portion having higher translucency and is receivedby the light sensor module 118. The light sensor module 118 sends asignal to the interface unit that determines the position of the plunger106 within the syringe housing 102, based on the opacity of band 130along the light sensor 120. Thus, the position of the plunger 106 can bedetermined. The interface may also determine the various types ofinformation listed above, based on a known diameter and length of thebore 104 of the syringe housing 102. Two finger rings or tabs 132receive the fingers of a user during use. A stop 134 prevents theplunger 106 from being pulled out of the syringe housing 102.

FIGS. 4A-4C depict various alternative configurations of plungers thatmay be utilized with various monitoring syringes herein. FIG. 4A depictsa partial enlarged perspective view of another embodiment of amonitoring syringe 200. In this embodiment, a plunger 206 includes ashaft 208. Rather than the discrete band depicted above in FIGS. 2 and3, the depicted embodiment includes a gradation 230 of varyingtranslucency/opacity along the plunger shaft 208. In the depictedembodiment, the gradation 230 is darker (i.e., less translucent or moreopaque) proximate the piston 210. Proximate the stop 234, thetranslucency of the gradation 230 is higher (and conversely, the opacitylower). The transition of the gradation may be smooth or in discretebands. In certain embodiments such as the one depicted in FIG. 4A, noshading may be present proximate the stop 234 and the translucency ofthat portion may be the same as that of the shaft 208, generally.

FIG. 4B depicts a partial enlarged perspective view of anotherembodiment of a monitoring syringe 300. In this embodiment, a plunger306 includes a shaft 308. Rather than the discrete higher opacity banddepicted above in FIGS. 2 and 3, the depicted embodiment utilizes ashaft 308 having a discrete band 330 of higher translucency. That is,the portion of the shaft 330 disposed between the piston 310 and stop334 is substantially opaque, while the band 330 is substantiallytranslucent.

FIG. 4C depicts a partial enlarged perspective view of anotherembodiment of a monitoring syringe 400. In this embodiment, a plunger406 includes a shaft 408. The gradation 430 is disposed opposite thegradation of the embodiment of FIG. 4A. In the embodiment of FIG. 4C,the gradation 430 is darker (i.e., less translucent or more opaque)proximate the stop 434. Proximate the piston 410, the translucency ofthe gradation 430 is higher. The transition of the gradation 430 may besmooth or in discrete bands. In certain embodiments, no shading may bepresent proximate the piston 410 and the translucency of that portionmay be the same as that of the shaft 408, generally.

Any of the configurations of the plungers depicted in FIG. 2, 3, or4A-4C may be utilized with the monitoring syringes depicted herein. Thatis, plungers having discrete bands of opacity or translucency, orplungers having increasing or decreasing gradations (measured from thepiston to the stop) may be utilized with syringes utilizing light sensormodules. Regardless of plunger opacity/translucency configuration, thelight sensor modules detect changes of light being received as themonitoring syringe is used. Depending on the location of one or morelight sensors within the light sensor module, the changes enable aninterface device to determine the position of the plunger and,accordingly, the volume and other characteristics or conditions of thedevice.

The various embodiments of measuring syringes of FIGS. 2-4C describedevices that generally include a light sensor module and/or light sensorpositioned on, in, or proximate the device housing or bore. The portionof the device including the variation of translucency is principallypositioned on, in, or proximate the device plunger. Of course, theconfiguration of the components can be reversed if desired, such thatthe housing/bore includes variations in translucency, while the plungerincludes a light sensor or light sensor module. These embodiments arealso considered within the scope of the technology.

FIGS. 5A-5C depict various embodiments of monitoring syringes. FIG. 5Adepicts a monitoring syringe 600 utilizing a sensor module 618. Thesensor module 618 includes a sensor housing 619 and a linear array 620.The linear array 620 includes a plurality of pixels 620 a. In thedepicted embodiment, the monitoring syringe 600 includes a plunger 606having a shaft 608 including a translucent band 630. The band 630 neednot be completely translucent, but merely sufficiently translucent suchthat the pixels 620 a within the light array 620 may detect a change inlight received. In this embodiment, the received light is ambient light640 that may be present in a room such as a surgical suite. Conversely,light source 640 may be from a source other than ambient light, such asan infrared or ultraviolet light generator, for example. Additionally,the light sensor module 618 may be configured with filters to receivelight of only a predetermined wavelength (e.g., infrared, ultraviolet,etc.). Alternatively, the plunger 606 or shaft 608 may be configuredwith a filter to filter the received light to the desired wavelength.

FIG. 5B depicts a monitoring syringe 700 utilizing a sensor module 718.The sensor module includes a sensor housing 719 and a light sensor 720that includes discrete light sensor elements 720 a, such as for example,photoresistors. In the depicted embodiment, the monitoring syringe 700includes a plunger 706 having a shaft 708 including a gradation 730,wherein the gradation 730 is less translucent proximate the piston 710and more translucent proximate the stop 734. Instead of utilizingambient light as with the previous embodiments, the monitoring syringeof FIG. 5B utilizes a light emitter module 750, such as, for example,light emitting diodes (LEDs). The light emitter module 750 is secured tothe syringe housing 702 in a manner similar to the light sensor module718. The light emitter module 750 includes an emitter housing 752 and alight emitter 740 including a plurality of light emitter elements 740 a.In the depicted embodiment, the discrete light emitter elements 740 amay be disposed opposite and aligned with the discrete light sensorelements 720 a, but this is not required. Additionally, the lightemitter elements 740 a may be configured to only emit light having aparticular wavelength, or the light may be filtered so as to restrictthe light that is emitted and/or sensed. As the gradation 730 passesbetween the light sensor module 718 and the light emitter module 750,light signals are received by the discrete light sensor elements 720 a.The light sensor module 718 sends signals to an interface, whichprocesses the signals to determine the position of piston 710. The lightsensor module 718 and light emitter module 750 are disposedapproximately 180 degrees from each other about the circumference of thesyringe housing 702. In other embodiments, the modules 718, 750 may bedisposed less than about 180 degrees from each other. In certainembodiments, the modules 718, 750 may be disposed about 90 degrees fromeach other. If desired, the modules 718, 750 may be contained in acommon housing.

FIG. 5C depicts a monitoring sensor 800 utilizing a sensor module 818.The sensor module includes a sensor housing 819 and a light sensor 820that includes discrete light sensor elements 820 a, such asphotoresistors. In the depicted embodiment, the monitoring syringe 800includes a plunger 806 having a shaft 808 including a gradation 830,wherein the gradation 830 is less translucent proximate the piston 810and more translucent proximate the stop 834. The monitoring syringe 800utilizes a light emitter module 850. The light emitter module 850 issecured to the syringe housing 802 in a manner similar to the lightsensor module 818. The light emitter module 850 includes an emitterhousing 852 and a light emitter 840 including a plurality of lightemitter elements 840 a. Note that the emitter housing 852 and sensorhousing 819 may include a structural element (e.g., tape or adhesive) tofacilitate fixation of emitters/sensors to the chamber, or may includeemitters/sensors being disposed within the chamber wall. In the depictedembodiment, the discrete light emitters 840 a are disposed opposite andaligned with the discrete light sensor elements 820 a, but this is notrequired. Additionally, the light emitter elements 840 a may beconfigured to only emit light having a particular wavelength (forexample, near infrared light generator), or may be filtered. As thegradation 830 passes between the light emitter module 818 and the lightsensor module 850, light signals are received by the discrete lightsensor elements 820 a. The light sensor module 818 sends signals to aninterface, which processes the signals to determine the position ofpiston 810. The light sensor module 818 and light emitter module 850 aredisposed approximately 180 degrees from each other about thecircumference of the syringe housing 802. In other embodiments, themodules 818, 850 may be disposed as described above with regard to FIG.5B. The monitoring syringe 800 of FIG. 5C utilizes a light sensor module818 and light emitter module 850 having higher sensor and emitterdensities than those of FIGS. 5A and 5B. As described above, this mayresult in greater positional accuracy.

FIG. 6 depicts another embodiment of a monitoring syringe 900. In thiscase, the light sensor housing 919, containing the light sensor 920 andwires 924, is detachably secured to the syringe housing 902. The lightsensor housing 919 may be secured with clips, C-clamps, resilientcatches, or other elements 960 that allow the light sensor housing 919to be removed from the syringe housing 902. Such a configuration may bedesirable so the light sensor housing 919 and related components may bereused on a different syringe, typically after a medical procedure. Thelight sensor housing 919 may be removed from a first syringe housing 902and reattached to a second syringe housing at a later time. Once thewires 924 (or similar connective instruments) are reconnected to theinterface (as described above) a calibration program may be executed soas to calibrate the light sensor module 918 for the new syringe.

The embodiments described herein may include various elements orcomponents to measure and/or detect a displacement of a plunger within achamber, such as a syringe. And, with the detection of a positionalrelationship of a plunger within a chamber, a user may explicitly orimplicitly determine a volume of media that may have been ejected from achamber. Some of the embodiments described may include various sourcesin the generation of light, as well as components to detect or sense thelight, depending on the positional relationship of the plunger/pistonand the chamber. Linear encoders, inductive sensors, capacitive touchsensors (with metal actuator in plunger), ultrasonic emitters/receivers,pressure sensors, optical encoders (with fine pitch slots and lightsource), strain gauges (i.e., to measure weight), electromagneticemitters/receivers (e.g., navigational systems) are alternativetechnologies contemplated for the use of measuring an injectiondelivered from an injector to a patient, with or without measuring a“diversion” reservoir. Other alternative embodiments capable ofidentifying positional relationships of a plunger and chamber (andchanges thereof) may include, without limitation, the followingtechnologies. A Hall sensor (coiled wire along syringe axis) may beplaced on, or in proximity to, the chamber with a magnet attached to theplunger (so as to act as a variable proximity sensor). Multiple lowsensitivity Hall sensors may be disposed along the chamber of thesyringe with a magnet attached to the plunger. Still other embodimentsof systems utilizing multiple Hall sensors are described herein. Laserlight may be emitted and detected to determine a positional relationshipof the plunger along the chamber axis. An absolute encoder may be usedto “read” the direct displacement of the plunger.

FIG. 9 depicts a perspective view of an embodiment of a monitoringsyringe 1200 utilizing a Hall sensor module, which is described in moredetail below. The monitoring syringe 1200 includes a syringe housing1202 defining an inner bore 1204. A plunger or piston, which isdescribed in more detail below, is slidably received in the bore 1204.More specifically, the piston is slidably engaged with an interiorsurface of the bore 1204 and linear movement M of a plunger shaft withinthe bore 1204 moves the piston. Movement M is along the syringe axisA_(S). A thumb ring 1212 may be utilized to push and pull the plungeralong axis A_(S), as described in more detail below. As the plunger ismoved M in a direction towards the discharge end 1214 a of the syringehousing 1202, the fluid (e.g., media) contained therein is dischargedinto a tube or needle (not shown) and delivered to a patient. Two fingerrings or tabs 1232 receive the fingers of a user during use. Note thatthroughout the description a cylindrical-type housing 1202 and innerbore 1204 are described; however, it is contemplated that there may be avariety of constructions of a housing/bore 1202/1204 and plunger thatprovide the function as anticipated herein and the shape (includingrectangular, ovular, triangular cross-section, etc.), in and of itself,should not be limiting. The monitoring syringe 1200 also includes a Hallsensor module 1250, described in more detail below. One component of theHall sensor module 1250 is a magnet retention ring 1252, which isdisposed on an outer or exterior surface of the syringe housing 1202. Inthe depicted embodiment, the magnetic retention ring 1252 is disposedproximate a proximal end 1214 b of the housing 1202, but it may bedisposed in other locations along the housing 1202.

FIG. 10 depicts a partial perspective sectional view of the monitoringsyringe 1200 of FIG. 9, depicting the Hall sensor module 1250. Certaincomponents 1250 a of the Hall sensor module 1250 are disposed within aninner chamber of a hollow shaft 1208 of the plunger 1206, while certaincomponents 1250 b are disposed on an exterior surface of the syringehousing. These various components 1250 a, 1250 b are described in moredetail below. So-called internal components 1250 a (i.e., internal tothe plunger 1206) include retention inserts 1254 a, 1254 b, a base orcircuit board 1256, and a plurality of Hall sensors 1258 disposedthereon. One or more batteries 1260 and a control switch 1262 may alsobe secured to the circuit board 1256. Signals from the Hall sensors 1258may be first processed by the circuit board 1256, which may determinethe position of the plunger 1206, the volume of media in the syringe,etc., and then send this information to an associated system via thetransmitter 1280 for further analysis, display to a doctor, etc. Inanother embodiment, e.g., if a non-processing base 1256 is used, thesignals from each Hall sensor 1258 may be sent directly via thetransmitter 1280 to an associated system for processing.

The distal retention insert 1254 a may be inserted into the shaft 1208so as to be near the piston 1210. The distal retention insert 1254 a maydefine a void 1264, which may contain a wireless transmitter 1280, suchas a Bluetooth transmitter. The transmitter 1280 may send signals fromthe Hall sensors 1258 to an associated signal processing device such asdescribed herein. In an alternative embodiment, a cable connection suchas described above, may be utilized. The proximal retention insert 1254b is disposed in the hollow shaft 1208 near the thumb ring 1212.Together, the distal retention insert 1254 a and the proximal retentioninsert 1254 b support, protect, and retain the circuit board 1256 withinthe hollow shaft 1208. These two components may be configured for a snugfit in the shaft 1208, or may include a key or other projection toengage with an opening or slot in the shaft 1208, so as to preventrotation. The retention inserts 1254 a, 1254 b may be permanently fixedwithin the shaft 1208, although configuring the inserts 1254 a, 1254 bfor removal may be advantageous so as to allow for replacement or repairof the circuit board 1256, batteries 1260, etc. In one embodiment, thethumb ring 1212 may include a resilient base 1264 including a pluralityof projections 1266 that may be engageable with mating slots 1268 in theshaft 1208. Disengaging these projections 1266 allows for removal of theretention inserts 1254 a, 1254 b and other internal components. Aplurality of Hall sensors 1258 are depicted. A greater or fewer numberof sensors 1258 may be utilized in various embodiments, although agreater number of sensors 1258 may provide for more accuratedeterminations with regard the position of the plunger 1206. The Hallsensors 1258 are disposed linearly within the chamber so as to besubstantially aligned with, or parallel to, the axis A_(S).

External components 1250 b include the magnet retention ring 1252, whichholds a plurality of magnets 1270, which are arc magnets, in thedepicted embodiment. In other embodiments, cube, cylindrical, or othermagnets may be utilized. The positions of the magnets 1270 are fixedrelative to and about the syringe housing. The arc magnets 1270 form asubstantially circular magnetic field through which the shaft 1208 (andthe Hall sensors 1258) pass when the shaft 1208 is withdrawn from orinserted into the inner bore of the syringe. The circular magnetic fieldenables the Hall sensors 1258 to detect the field, regardless of therotational position of the plunger 1206 about the axis A_(S). In otherembodiments, the magnets 1270 may be secured directly to the syringehousing without the magnet retention ring.

FIG. 11 depicts a partial exploded perspective view of a portion of themonitoring syringe 1200, as seen in FIG. 10. More specifically, theplunger 1206, Hall sensor module internal components 1250 a, and Hallsensor module external components 1250 b are depicted. In general,certain of these components are described above in FIGS. 9-10 and arenot necessarily described further. In the depicted embodiment, however,both the distal retention insert 1254 a and proximal retention insert1254 b include shaped recesses 1272 that are configured to receive thecircuit board 1256 so as to hold that element in place. The recesses1272 are disposed in the inserts 1254 a, 1254 b so as to conserve spacewithin the hollow shaft 1208 of the plunger 1206. On a side of thecircuit board 1256 opposite the Hall sensors 1258 are disposed aplurality of batteries 1260. This is also depicted in FIG. 12.Additionally, a switch 1262 may be disposed proximate the batteries 1260or elsewhere within the hollow shaft 1208. The switch 1262, in certainembodiments, may be a reed switch that detects plunger movement andmoves to an engaged or activated position. The switch 1262 is notrequired but may help preserve power when the syringe 1200 is not inuse. When activated, the switch 1262 selectively connects power from thebatteries 1260 to either or both of the plurality of Hall sensors 1258and the wireless transmitter 1280. In other embodiments, amanually-operated switched, such as a pull tab, button, or rocker switchmay be actuated by the user.

In a further embodiment of a system, the measurement components of amonitoring syringe 1200 could also be utilized to measure a volume ofmedium diverted by a modulator to a medium diversion reservoir, insystems that employ a reservoir in the introduction of contrast to apatient. Such medium diversion reservoirs, and their incorporation intorelated medium management and monitoring systems, are describedelsewhere herein. In such cases, the inner bone 1204 may form a fluidreservoir to capture medium that may diverted by a modulator away fromthe injection of medium to the delivery catheter. In an additionalembodiment of a reservoir, the chamber may be sufficiently pressurizedby a force acting upon the plunger 1206 to facilitate controlledfilling, release and measurement of a medium within the chamber. Theforce may bias the piston 1210 into the fluid contained in the bore1204, while the Hall sensors 1258 continue to detect a position of theplunger 1206. In the depicted example, to configure the monitoringsyringe 1200 as a pressurized diversion reservoir, a spring 1209 may bedisposed about the hollow shaft 1208 of the plunger 1206. This spring1209 biases the piston 1210 towards the discharge end 1214 a of thesyringe housing 1202. Other spring configurations and/or biasingmechanisms may be utilized, wherein they may be generally disposed aboutthe syringe axis A_(s) so as to provide for a balanced application offorce.

FIG. 13 depicts a perspective view of a second embodiment of amonitoring syringe 1300 utilizing a Hall sensor module. The monitoringsyringe 1300 includes a syringe housing 1302 defining a hollow innerbore. A plunger 1306 including a shaft 1308 and a piston 1310 isslidably received in the bore. More specifically, the piston 1310 may beslidably engaged with an interior surface of the bore and linearmovement M of the shaft 1308, within the bore, moves the piston 1310.Movement M is along the syringe axis A_(S). The plunger 1306 is movedback and forth within the bore 1304 by the movement of a thumb pad, suchas a thumb-ring 1312. As the plunger 1306 is moved M in a directiontowards the discharge end 1314 a of the syringe housing 1302, the fluidcontained therein is discharged into a manifold assembly, tube, orneedle (not shown) and delivered to a patient.

As an alternative embodiment to that depicted in FIGS. 10-11, a Hallsensor module 1318 may be secured to an exterior surface of the syringehousing 1302, rather than securement to the plunger. The Hall sensormodule 1318 includes a Hall sensor housing 1319 that encloses aplurality of Hall sensors 1320. As described above with regard to FIGS.9-11, a greater number of discrete Hall sensor elements may improveaccuracy. One or more leads or wires 1324 extend from an end of the Hallsensor module 1318. A cable 1326 connects at an end 1328 to an interfaceunit that analyzes the output of the Hall sensor module 1318 andprovides this information to a user of the monitoring syringe 1300,typically on a display. In other embodiments, communication may be via aradio, Bluetooth, of other wireless connection, as described herein. Thedisplayed information may include volume of the chamber, volumeremaining, volume dispensed, fluid type, flow rate, fluid pressure ortemperature and/or other information, as required or desired for aparticular application. As described above, the signals from the Hallsensors may first be processed by an associated circuit board then sentto an interface unit, or the discrete signals may be sent to theinterface unit for processing.

In the depicted embodiment, the shaft 1308 of the plunger 1306 has oneor more magnets 1330 disposed thereon or within the shaft 1308. Themagnet 1330, in this case, includes a plurality of arc magnets disposedabout the shaft 1308. As the plunger 1306 is slidingly moved M along theaxis A_(S), the magnet 1330 passes in front of the Hall sensors 1320 ofthe Hall sensor module 1318. The magnetic field generated by the magnet1330 is detected by the Hall sensor 1320. The Hall sensor 1320 sends asignal to the interface unit that determines the position of the plunger1306 within the syringe housing 1302, based on the position of themagnet 1330 as detected by an individual Hall sensor 1320. Thus, theposition of the plunger 1306 can be determined. The interface may alsodetermine the various types of information listed above, based on aknown diameter and length of the bore 1304 of the syringe housing 1302.Two finger rings or tabs 1332 receive the fingers of a user during use.A stop 1334 prevents the plunger 1306 from being pulled out of thesyringe housing 1302.

Although the embodiments depicted in FIGS. 9-13 depict a plurality ofHall sensors, other embodiments of monitoring syringes may utilize oneor more sensors of various types. For example, a single sensor, ormultiple sensors, may be used to measure a magnetic field, materialresistance, capacitance, etc. The measurements from such sensors may beutilized to determine the linear position of the plunger within thesyringe. Examples of such sensors include, but not limited to, Halleffect sensors (as described in more detail herein), inductive sensors,capacitive touch sensors, and others.

FIG. 7A depicts a first method 1000 a of using a monitoring syringeutilizing light signals. At operation 1002 a, a signal is received froma light sensor, the position of which on a monitoring syringe is known.Other characteristics of the light sensor, such as receptive wavelength,may be known. Based on the position of the light sensor and the signalreceived from said sensor, a position of a piston is then determined inoperation 1004 a. In certain embodiments of the method 1000 a, a lightsignal is emitted from the first emitter in operation 1006 a. Inembodiments where multiple light sensors are used, a light signal may bereceived at a second light sensor having known characteristics (e.g.,position) in operation 1008 a. An updated position may then bedetermined based on the characteristic of the second light sensor andthe signal in operation 1010 a. At any time a light signal is receivedfrom a known light sensor, a condition of the syringe (such as thosedescribed herein) may be determined, as in operation 1012 a.

FIG. 7B depicts a second method 1000 b of using a monitoring syringeutilizing Hall sensors. At operation 1002 b, a signal is received from afirst Hall sensor, the position of which in a plunger shaft is known,relative to other Hall sensors in the shaft. Based on the position ofthe first Hall sensor and the signal received from said sensor, aposition of a piston is then determined in operation 1004 b. Since across-sectional area, diameter, or other dimension of the syringe isknown, the amount of media in the syringe based on the position of thepiston can be determined. In embodiments where multiple Hall sensors areused, a signal may be received from a second Hall light sensor havingknown characteristics (e.g., position) in operation 1006 b. An updatedposition of the piston may then be determined based on the receivedsignal from the second Hall sensor and the signal in operation 1008 b.At any time a signal is received from a known Hall sensor, a conditionof the syringe (such as those described herein) may be determined, as inoperation 1010 b. As described above, the method 1000 b may be performedon the circuit board within the monitoring syringe, then sent to anassociated system via the transmitter for further analysis or display toa surgeon, etc. In an alternative embodiment, each signal may be sentvia the transmitter to an associated system for processing, analysis,display, etc.

In addition, the methods described in FIGS. 7A-7B, when used in a systememploying a diversion reservoir, may further incorporate a measurementdetermined in a chamber collecting medium diverted from an injection(i.e., through a modulator). Having a total amount of medium injected bythe syringe (as determined by a sensing apparatus), minus the amount ofmedium diverted (as determined by a sensing apparatus), provides thetotal amount of the injection actually delivered to the patient.

FIG. 8 illustrates one example of a suitable operating environment 1100in which one or more of the present embodiments may be implemented. Thisis only one example of a suitable operating environment and is notintended to suggest any limitation as to the scope of use orfunctionality. Other well-known computing systems, environments, and/orconfigurations that may be suitable for use include, but are not limitedto, personal computers, server computers, hand-held or laptop devices,multiprocessor systems, microprocessor-based systems, programmableconsumer electronics such as smart phones, network PCs, minicomputers,mainframe computers, smartphones, tablets, distributed computingenvironments that include any of the above systems or devices, and thelike.

In its most basic configuration, operating environment 1100 typicallyincludes at least one processing unit 1102 and memory 1104. Depending onthe exact configuration and type of computing device, memory 1104(storing, among other things, instructions to perform the monitoringmethods described herein) may be volatile (such as RAM), non-volatile(such as ROM, flash memory, etc.), or some combination of the two. Thismost basic configuration is illustrated in FIG. 8 by line 1106. Further,environment 1100 may also include storage devices (removable, 1108,and/or non-removable, 1110) including, but not limited to, magnetic oroptical disks or tape. Similarly, environment 1100 may also have inputdevice(s) 1114 such as touch screens, keyboard, mouse, pen, voice input,etc. and/or output device(s) 1116 such as a display, speakers, printer,etc. Also included in the environment may be one or more communicationconnections, 1112, such as LAN, WAN, point to point, Bluetooth, RF, etc.

Operating environment 1100 typically includes at least some form ofcomputer readable media. Computer readable media can be any availablemedia that can be accessed by processing unit 1102 or other devicescomprising the operating environment. By way of example, and notlimitation, computer readable media may comprise computer storage mediaand communication media. Computer storage media includes volatile andnonvolatile, removable and non-removable media implemented in any methodor technology for storage of information such as computer readableinstructions, data structures, program modules or other data. Computerstorage media includes, RAM, ROM, EEPROM, flash memory or other memorytechnology, CD-ROM, digital versatile disks (DVD) or other opticalstorage, magnetic cassettes, magnetic tape, magnetic disk storage orother magnetic storage devices, solid state storage, or any othertangible medium which can be used to store the desired information.Communication media embodies computer readable instructions, datastructures, program modules, or other data in a modulated data signalsuch as a carrier wave or other transport mechanism and includes anyinformation delivery media. The term “modulated data signal” means asignal that has one or more of its characteristics set or changed insuch a manner as to encode information in the signal. By way of example,and not limitation, communication media includes wired media such as awired network or direct-wired connection, and wireless media such asacoustic, RF, infrared and other wireless media. Combinations of the anyof the above should also be included within the scope of computerreadable media.

The operating environment 1100 may be a single computer operating in anetworked environment using logical connections to one or more remotecomputers. The remote computer may be a personal computer, a server, arouter, a network PC, a peer device or other common network node, andtypically includes many or all of the elements described above as wellas others not so mentioned. The logical connections may include anymethod supported by available communications media. Such networkingenvironments are commonplace in offices, enterprise-wide computernetworks, intranets and the Internet. In some embodiments, thecomponents described herein comprise such modules or instructionsexecutable by computer system 1100 that may be stored on computerstorage medium and other tangible mediums and transmitted incommunication media. Computer storage media includes volatile andnon-volatile, removable and non-removable media implemented in anymethod or technology for storage of information such as computerreadable instructions, data structures, program modules, or other data.Combinations of any of the above should also be included within thescope of readable media. In some embodiments, computer system 1100 ispart of a network that stores data in remote storage media for use bythe computer system 1100.

The monitoring syringes such as those described above may be utilized invarious types of medium management systems to control and monitor mediuminjection into patients. Two exemplary medium management systems, aswell as components thereof, are described below in the followingfigures. These are but two types of systems that may benefit from themonitoring technologies described herein. Other systems andconfigurations thereof will be apparent to a person of skill in the art.

FIGS. 14-16 illustrate another medium management system 1400 that mayinclude, as shown in the illustrated embodiment, a flow diverterassembly (i.e., a modulator) 1402 and a diversion reservoir 1404. Inthis embodiment, tubular member 1406 a extends from the valve 1426 ofthe flow diverter assembly 1402 to a medium diversion reservoir 1404,and tubular member 1406 b extends from diversion reservoir 1404 tomedium reservoir (e.g., contrast agent vial) 1410. Medium from themedium reservoir 1410 (e.g., contrast agent vial) is permitted to flowaway from the medium reservoir 1410 and through diversion reservoir 1404via tubular members 1406 b and tubular member 1412. In the illustratedarrangement (of FIG. 14), syringe 1414 may be fluidly coupled to mediumreservoir 1410 by tubular members 1406 b, 1412, 1416 and 1418, couplingthose components together by a manifold 1420 and through stopcock 1422.When the syringe 1414 is being loaded with medium from medium reservoir1410, the stopcock 1422 may be positioned to permit medium flow betweentubular members 1416 and 1418, but not to tubular member 1424 disposedbetween the stopcock 1422 and the valve 1426 of the flow diverterassembly 1402. The syringe 1414 may be any of the monitoring syringesdescribed herein (e.g., using light sensors, Hall sensors, etc.) or ofthe monitoring syringes known in the art. Drawing back the syringe 1414may pull medium from the medium reservoir 1410 through tubular member1406 b, and/or diversion reservoir 1404, and through tubular member1412. Medium from the medium reservoir 1410 and/or medium residing inthe diversion reservoir 1404 may then be further drawn, into and toward,syringe 1414 through tubular members 1416 and 1418. Once the syringe1414 is loaded with medium from medium reservoir 1410 and/or diversionreservoir 1404, valve B on manifold 1420 may then be manipulated toprohibit flow back to medium reservoir 1410 and diversion reservoir 1404via tubular member 1412 (and such flow may be further inhibited by acheck valve disposed between diversion reservoir 1404 and mediumreservoir 1410), and the stopcock 1422 may be positioned to allow flowthrough the tubular members 1418, 1424, 1416 and manifold 1420.

During contrast injection procedures incorporating a modulator (such asflow diverter assembly 1402) a portion of the injected medium flow fromthe syringe 1414 may be diverted away from the medium flow path toinjection catheter 1428 by the flow diverter assembly 1402. In themodulation/reservoir system 1400 illustrated in FIGS. 14-16, suchdiverted medium flow passing through the flow diverter assembly 1402flows into the diversion reservoir 1404, as opposed to the divertedmedium flowing directly into the medium reservoir 1410 or some otheroutflow/overflow reservoir/chamber. Advantageously, the diversionreservoir 1404 provides means for collecting overflow medium diverted bythe flow diverter assembly 1402, for possible re-use as the syringe 1414may be again activated to pull medium into the system (e.g., forintroduction into the patient via catheter 1428). The use of such adiversion reservoir in this manner, with an associated check valvepreventing back flow of medium into the medium reservoir 1410, allowsfor capture and re-use of medium that is already introduced into thesystem (e.g., in the diversion reservoir 1404) while preserving theintegrity of the medium disposed within medium reservoir 1410 in itsoriginal form.

The medium management system 1400 may also include a saline reservoir1430 that can be used to flush portions thereof. In the depicted system1400 of FIG. 14, the saline reservoir 1430 is connected to the manifold1420 via a tube 1432 and can be isolated from the remainder of thesystem 1400 with valve A. Valve A may include a position or other sensorS that detects a position of the valve A. A flush signal is sent fromthe valve A sensor S to a monitoring/display system 1434, which also maybe configured to monitor the position of valve B and stopcock 1422(using sensors S), as well as the output from the various sensors on themonitoring syringe 1414 and/or the sensors on the diversion reservoir1404. For example, when the valve A is in an open position, themonitoring/display system 1434 may disregard signals from the monitoringsyringe 1414 and/or diversion reservoir 1404 (as those readings are notreflective of contrast being injected from or drawn into the syringe1414). In another example, if the valve A is in an open position, themonitoring/display system 1434 may display an instruction or emit asignal to remind an operator to close valve B and/or stopcock 1422 so asto isolate those portions of the system 1400. In another, more complexexample, the system 1400 uses automated valve B and/or stopcock 1422 andcloses these valves upon receiving an open signal from valve A.

One embodiment of the diversion reservoir 1404 is illustrated in FIGS.15A-15D. FIG. 15A shows an assembled view of diversion reservoir 1404along with its associated tubular members 1406 a and 1412. FIG. 15B isan exploded view of the assembly of FIG. 15A. The system 1400 mayfurther include a second supply conduit 1412 in fluid communication withthe supply conduit 1406 b and the diversion conduit 1406 a, wherein thesecond supply conduit 1412 is fluidly coupled to the fluid medium flowpath. Tubular members 1406 a and 1412 are sealably connected to a firstend cap or manifold 1502 on diversion reservoir 1404, as further shownin FIG. 15C, which is a sectional view taken through lines 15C-15C inFIG. 15A. A first end of a through-tube 1506 is sealably connected to aninterior side of first end cap 1502, as at 1504. Through-tube 1506includes an inner conduit 1508 extending therethrough. Inner conduit1508 is in fluid communication with the interiors of tubular members1406 a and 1412 via their adjacent couplings in the first end cap 1502,as illustrated in FIG. 15C. A second end of through-tube 1506 issealably connected to a check valve assembly 1540, as at 1510, and theinner conduit 1508 is in fluid communication with the check valveassembly 1540. The check valve assembly 1540 is, in turn, in fluidcommunication with the tubular member 1406 a. As seen in FIG. 15C, thecheck valve assembly 1540 includes a moveable valve plate 1512 (or othersuitable structure allowing one way flow through the valve) which isoperable to permit flow from the medium reservoir 1410 (e.g., mediumcontrast vial) via tubular conduit 1406 b into the inner conduit 1508 ofthrough-tube 1506, but to inhibit flow in reverse thereof. Thisarrangement may allow flow of medium from fluid reservoir 1410 viatubular conduit 1406 b, inner conduit 1508 of through-tube 1506, andtubular conduit 1412 to the syringe 1414. Moreover, medium flow divertedby flow diverter assembly 1402 may also be permitted to flow via tubularmember 1406 a into inner conduit 1508 of through-tube 1506, butinhibited from flowing to the medium reservoir 1410 by check valveassembly 1540. A second end cap 1514 on diversion reservoir 1404 issecured about the check valve assembly 1540.

The diversion reservoir 1404 is designed to accommodate flow of mediumfrom the flow diverter assembly 1402, to collect and hold such mediumand then, if desired, urge such collected medium back into the systemfor use in delivering additional medium to the patient via injectioncatheter 1428. In one embodiment to accomplish this end, diversionreservoir 1404 may include an elastic expansion tube 1516 disposed aboutthrough-tube 1506. As seen in FIGS. 15C and 15D, expansion tube 1516extends along a portion of a length of through-tube 1506. Expansion tube1516 may be formed of silicone (or like flexible) material sealablysecured adjacent each end thereof about the through-tube 1506 by firstand second retention washers 1518 and 1520, respectively, or by othersuitable sealable and mechanical fastening arrangements. An outersurface of the through-tube 1506 may include interference elements suchas surface features or an annular interference rim 1506 a (see FIG. 15C)to further facilitate the sealing of the expansion tube 1516 to thethrough-tube 1506 via the retention washer 1518 and 1520.

A housing tubular outer shell 1522 may be connected between the firstend cap 1502 and second end cap 1514, thereby covering the expansiontube 1516 and other diversion reservoir components therein. The shell1522 may serve to protect the components of the diversion reservoir 1404therein, limit the extent of inflation or expansion of expansion tube1516, and/or (if the shell 1522 is either transparent or translucent)allow observation of the condition (e.g., expanded state) of expansiontube 1516 therein.

FIG. 15D illustrates the diversion reservoir 1404 in perspectivesectional view (again, as taken along lines 15C-15C in FIG. 15A) withthe expansion tube 1516 shown in an exemplary stretched and expandedstate, as opposed to its relaxed state shown in FIG. 15C. The expansiontube 1516 of the diversion reservoir 1404 receives medium flow from theflow diverter assembly 1402, via tubular member 1406 a. This mediumflow, as illustrated by flow arrows 1524 in FIG. 15D, flows from tubularmember 1406 a into the inner conduit 1508 of through-tube 1506 adjacentthe first end of through-tube 1506. Through-tube 1506 can be a portionof the medium supply conduit 1406 b that resides within reservoirchamber 1526. Flow out of the through-tube 1506 is inhibited at itssecond end by the check valve assembly 1540. However, the supply conduitthrough-tube 1506 may have one or more apertures 1528 therethrough whichallows an interior of the expansion tube 1516 to be in fluidcommunication with the inner conduit 1508 and reservoir chamber 1526.Medium from the flow diverter assembly 1402 can thus flow throughapertures 1528 and into a medium reservoir or chamber 1526 defined bythe expansion tube 1516. This medium chamber 1526 is defined between theinner surface of expansion tube 1516 and the outer surface ofthrough-tube 1506, whereby the expansion tube 1516 forms an elasticbladder disposed around the supply conduit 1506, with the walls ofexpansion tube 1516 capable of imparting a force on the fluid mediumwithin the chamber 1526. A surface within chamber 1526 is capable ofimparting a variable or constant force on the fluid medium within thechamber 1526, and the surface is defined at least in part by a wall ofthe elastic bladder of expansion tube 1516. The medium chamber 1526 thusreceives and collects the diverted portion of the flow of medium fromthe flow diverter assembly 1402. The diversion reservoir 1404 comprisesa variable or constant force biasing member disposed relative to atleast one surface within the reservoir chamber 1526 to urge the surfaceagainst the fluid medium within the reservoir chamber 1526. Theexpandable wall of the expansion tube 1516 thus defines a surface withinthe medium chamber 1526 capable of imparting a force (variable orconstant) on the fluid medium within the medium chamber 1526. In oneembodiment, the second end cap 1514 includes an aperture 1530therethrough to permit the escape of gas within the cover 1522 andthereby readily permit expansion of the expansion tube 1516 therein.

In use, as the pressure of medium within the flow diverter assembly 1402increases enough to allow flow therethrough, medium flows from thediverter valve 1426 via the tubular member 1406 a to the diversionreservoir 1404. Fluid coupling is provided by a medium supply conduit1406 b disposed between, and fluidly coupled to, the diversion reservoir1404 and the sterile medium container 1410. A diversion supply conduit1406 a is disposed between, and fluidly coupled to, the diversionreservoir 1404 and the flow diverter assembly 1402 so as to supply thereservoir 1404 with the diverted portion of the fluid medium from theflow diverter assembly 1402. Medium flows within the diversion reservoir1404 as illustrated by arrows 1524 into medium chamber 1526, therebystretching the walls of the expansion tube 1516 and expanding chamber1526 to accommodate the diverted medium flow. Accordingly, as the mediumpressure provided via syringe 1414 increases in the system, the flowdiverter assembly 1402 relatively diverts medium so that the flow to thepatient relatively increases as relatively less flow is diverted by theflow diverter assembly 1402 into the diversion reservoir 1404. Themedium contained in the chamber 1526 may be available for furtherinfusion into the patient via the modulation/reservoir system 1400. Asan example, an operator may activate valve B to allow medium flow fromthe chamber 1526 of the diversion reservoir 1404 into the syringe 1414(which is being withdrawn to draw such fluid therein). If the fluidneeded is greater than the volume retained within the chamber 1526, theforce of check valve 1512 is overcome and further medium is withdrawnfrom the medium reservoir 1410 (e.g., contrast agent vial). Once asufficient amount of medium has been withdrawn from the chamber 1526and/or reservoir chamber 1410, valve B may be closed and themodulation/reservoir system 1400 may be again in condition for deliveryof medium via injection catheter 1428, by activation of injectionsyringe 1414 by an operator. As long as the stopcock 1422 is disposed toallow flow into tubular members 1416 and 1424, the flow modulatorassembly 1402 may automatically activate to divert excess medium,thereby ultimately reducing the amount of medium introduced into thepatient via injection catheter 1428 (e.g., thus introducing no moremedium than necessary to attain operative opacity). In one embodimentshown, as the pressure is increased in the modulator 1402, theresistance to medium flow into the diversion circuit is increased byoperation of the flow diverter assembly 1402. The process may berepeated by an operator as many times as deemed necessary to completethe procedure desired. Use of the modulation/reservoir system 1400 inthis manner may achieve the advantageous reduction of introduction ofunnecessary medium into the patient while achieving the necessary amountand flow of medium in the patient for diagnostic or treatment means(e.g., for opacity). In addition, the diversion reservoir 1404 may allowre-use of the diverted outflow of medium.

The diversion reservoir illustrated in FIGS. 15A-15D presents one formof such a reservoir. Alternative forms are contemplated as well. Forexample, an alternative form of elastic bladder or elastic surface maybe provided that functionally allows the receipt of medium overflow fromthe flow diverter assembly 1402 into an expansion chamber, and thenfurther allows the flow of medium from the medium reservoir 1410 throughthe diversion reservoir 1404 and into the modulation/reservoir system1400 for use. An alternative means of placing force on the medium withinthe chamber in the diversion reservoir 1404 may be attained by a biasplunger, such as illustrated schematically in FIG. 16. The divertedportion of the fluid medium flows through a diversion conduit 1406 aaway from the flow diverter assembly 1402. The system 1400 comprises amedium reservoir 1410 containing a supply source of fluid medium for thesystem 1400 and a supply conduit 1406 b through the reservoir chamber1602 that fluidly connects the medium reservoir 1410 and the diverterconduit 1406 a. The supply conduit 1406 b comprises a check valve 1508 ato prevent the flow of fluid medium from the supply conduit 1406 b intothe medium reservoir 1410. Diversion reservoir 1404 a includes a plunger1604 slidably disposed in housing 1606 and moveable in a linear fashionrelative to the housing 1606, as illustrated by movement line 1608.Thus, the surface 1610 is movable in a linear direction relative to thefluid medium within the reservoir chamber 1602. A proximal face orsurface 1610 of the plunger 1604 thus defines a portion of a chamber1602 within the housing 1606 for diverted medium that is receivedtherein via the tubular member 1406 a.

Like the diversion reservoir 1400 illustrated in FIGS. 15A-15D,diversion reservoir 1404 a may include a first end cap 1502 a that actsas a manifold for medium flow. Tubular member 1406 a is connected tofirst end cap 1502 a, as is tubular member 1412. Chamber 1602 is influid communication with the interiors of tubular members 1406 a and1412, such as via manifold 1612 within the first end cap 1502 a, as seenin FIG. 16. A through-tube 1506 a is also in fluid communication withthe manifold 1612, and extends through the housing 1606 of the diversionreservoir 1404 a to a check valve 1508 a. Check valve 1508 a permitsmedium flow from medium reservoir 1410 via tubular member 1406 b intothrough-tube 1506 a but prevents backflow. Medium from the mediumreservoir 1410 can then flow from the diversion reservoir 1404 a intothe syringe 1414 via tubular member 1412.

When medium is diverted by the flow diverter assembly 1402 into thediversion reservoir 1404 a, medium flows as illustrated by flow arrows1524 a from tubular member 1406 a, through manifold 1612, and into thechamber 1602. The diversion reservoir 1404 a comprises a variable orconstant force biasing member such as spring 1614 disposed relative toat least one surface 1610 within the reservoir chamber 1602 to urge thesurface 1610 against the fluid medium within the reservoir chamber 1602.In an exemplary embodiment, surface 1610 is planar. The face 1610 of theplunger 1604 is biased by spring 1614 toward the manifold chamber 1612,and thus defines a moveable surface 1610 for the chamber 1602 that canmove away and expand chamber 1602 as more medium is introduced therein,when the bias of the force acting against it is overcome. This bias actson the plunger 1604 within the housing 1606, as illustratedschematically by force arrows 1616, and such force may be achieved bysuitable means such as springs, weight distribution, linear actuator, orother force elements. The use of a linearly moving plunger 1604 (as itsmovement is illustrated by arrows 1608) may permit more readymeasurement of how much medium has actually been diverted by the flowdiverter assembly 1402 and thereby, by derivation, how much medium hasactually been delivered to a patient by the injection catheter 1428.Measurement may be performed by utilizing a light-based, Hallsensor-based, or other type of monitoring system 1618 disposed in or onthe housing 1606, or in or on other structures (such as the plunger) ofthe diversion reservoir 1404, as such systems are described herein. Theplunger 1604 thus provides a linear expansion element (surface 1610)that serves to apply force to the overflow medium collected for possiblere-use in the chamber 1602.

The diversion reservoir 1404 a operates in a similar manner to thediversion reservoir 1404, discussed above, by providing an expandablechamber for medium diverted by the flow diverter/modulating assembly1402, wherein the chamber (e.g., chamber 1602, 1526) has at least onesurface acting upon it to urge the medium therein back toward theinjection device 1414 (via conduit 1412) for possible re-use. Likewise,medium which has been diverted by the flow diverter assembly 1402 intothe diversion reservoir chamber 1602 is not permitted to flow back tothe diverter assembly 1402, nor to flow to the medium reservoir 1410(via check valve 1508 a). In alternative embodiments formodulation/reservoir systems, the diversion reservoir is configured sothat flow through it to the medium reservoir 1410 is not permitted ornecessary. One such arrangement is illustrated in FIG. 17, in connectionwith a modulation/reservoir system 1400 a. In these arrangements, theremay be no necessity for a through-tube arrangement through the diversionreservoir. The diversion reservoir simply provides an expandable chambertherein for retaining and re-using medium diverted from the flowdiverter assembly 1402. Such diversion reservoirs 1404 b may employ abladder form of chamber or a constant or variable force resistance formof chamber, such as those illustrated and discussed herein, where atleast one surface therein is capable of imparting a sufficient forceupon the fluid medium within the chamber. For example, the diversionreservoir 1404 b may be constructed to function similar to thespring-based monitoring syringe 1200 depicted in FIG. 11. Although the“injection function” of the syringe 1200 may not be needed to functionas a diversion reservoir, one can see the advantages of using themeasurement capabilities derived from the chamber as described in FIG.11 as it might function as a “diversion reservoir”, utilizing spring1209 to bias piston 1210. FIG. 17 illustrates an arrangement where themedium reservoir chamber 1410 is connected via tubular member 1406 c toa T-connector 1702 disposed between a diversion reservoir 1404 b(without a through-tube) and the flow diverter assembly 1402. TheT-connector 1702 connects at its first end to the tubular members 1412and 1406 a and at its second end to tubular member 1406 d that leads tothe diversion reservoir 1404 b. A side fitting of the T-connector 1702leads via tubular member 1406 c to the medium reservoir 1410. A checkvalve 1508 b is disposed between the T-connector 1702 and the mediumchamber 1410 to prevent back flow of medium from the flow diverterassembly 1402 and/or diversion reservoir 1404 b into the mediumcontainer 1410. In operation, the configuration illustrated in FIG. 17may be similar to that described above with respect to FIG. 14. As thepressure of medium within the flow diverter assembly 1402 increasesenough to allow flow therethrough, medium flows from the valve 1426 viatubular member 1406 a to the T-connector 1702. Medium may then flow fromthe T-connector 1702 via tubular member 1406 d to the diversionreservoir 1404 b. Medium flowing into the diversion reservoir 1404 bmoves the piston therein to accommodate the diverted medium flow. Inoperation, medium provided via syringe 1414 may be diverted by the flowdiverter assembly 1402 away from injection to the patient, andaccumulate in the diversion reservoir 1404 b.

The medium contained in the expandable chamber within the diversionreservoir 1404 b may be available for further infusion into the patientvia the modulation/reservoir system 1400 a. To do so, an operatoractivates valve B to allow medium flow from the chamber within thediversion reservoir 1404 b into the syringe 1414 (which is beingwithdrawn to draw such fluid therein). If the fluid needed is greaterthan the volume retained in the chamber reservoir 1404 b, the force ofcheck valve 1508 b is overcome and further medium is then withdrawn fromthe medium reservoir 1410. Once a sufficient amount of medium has beenwithdrawn from the chamber within the diversion reservoir 1404 b and/orreservoir chamber 1410, valve B is again closed and the modulationsystem 1400 a is again in condition for delivery of medium via injectioncatheter 1428, by activation of injection syringe 1414 by an operator.As long as the stopcock 1422 is disposed to allow flow into tubularmembers 1416 and 1424, the flow diverter assembly 1402 will then againbe automatically activated to divert excess medium when a thresholdpressure for activation of the flow diverter assembly 1402 is attained,thereby ultimately reducing the amount of medium introduced into thepatient via injection catheter 1428. Again, as pressure is increasinggoing into flow diverter system 1402, the flow through the diverter 1402is relatively decreasing (thus, flow to the patient may be relativelyincreasing at the same time by operation of the flow diverter assembly1402). The process can be repeated by an operator as many times asdeemed necessary to complete the procedure desired. Use of themodulation/reservoir system 1400 a in this manner achieves theadvantageous reduction of introduction of unnecessary medium into thepatient while achieving the necessary amount and flow of medium in thepatient for the desired diagnostic or treatment process. Furthermore,the modulating/reservoir assembly may advantageously allow an operatorto change out the injection delivery system (i.e., guide catheter,diagnostic catheter, treatment tools, etc.) without changing the flowmodulator. Moreover, the diversion reservoir may allow simplistic re-useof the diverted medium.

FIG. 18 depicts a method 1800 of determining an amount of mediuminjected into a patient. The method begins at operation 1802, where aninjection signal is received from a sensor associated with an injectionsyringe. In operation 1804, a diversion signal is received from a sensorassociated with a diversion reservoir. Each of the injection signals andthe diversion signals may be received from the various types ofmonitoring systems as described herein, including light-based sensorsystems, Hall sensor-based systems, and so on. These signals can includeposition signals (e.g., position of the piston), which may be used todetermine a volume of medium contained within the injection syringeand/or the diversion reservoir. With this information, the amount ofmedium injected may be determines based at least in part on theinjection signal and the diversion signal, in operation 1806. In anexample, the amount injected is the difference between the volume in theinjection syringe minus the volume in the diversion reservoir.Operations 1802-1806 are constantly updated as medium is injected intothe patient.

In operation 1808, a signal associated with the amount of mediuminjected is sent. The summation of the total amount medium injected in apatient over time can be maintained. Signals and measurement data may beprovided to an operator in the form of an audible or visual signal whichcan indicate to the operator of the system (i.e., a surgeon ortechnician) the amount of fluid injected. The signals can include avisual display of the amount injected (e.g., on a monitoring display),or a signal that may indicate to the user that a maximum amount ofcontrast has been injected, or that none of the medium ejected from thesyringe has been received in the diversion reservoir (which may be anindication of a valve or system problem). The systems described hereinalso include a saline flush system. Saline volumes passing through thesystem should be ignored so the amount of medium injected is notincorrectly calculated. As such, the method 1800 contemplates receivinga flush signal associated with a valve of a saline flush system,operation 1810. At operation 1812, subsequent injection signals and/ordiversion signals are disregarded based at least in part on the receivedflush signal. The injection and/or diversion signals may be ignoredwhile the flush signal is still received, which allows the operator toflush the system without the saline volume passing through the systemcausing a miscalculation of the injected medium. In optional operation1814, a position of at least one valve based at least in part on theflush signal may be adjusted, if automated valves are being utilized inthe system. Otherwise, in systems where manual valves are used, theflush signal received in operation 1810 may cause a signal to beemitted, which may be used to signal an operator to close the valves notassociated with the flush system (e.g., valve B and stopcock 1422 inFIG. 14). Further, it is assumed that it is understood that the order ofthe steps in FIG. 18 maybe performed in a different order as shownwithout deterring from the scope of the invention. As an example,without being wholly inclusive, one might collect data from thediversion sensor before the injection sensor

The monitoring systems described herein may be utilized to deliver anytypes of fluids to a patient during a medical procedure. Such fluids mayinclude medium (media), agents, substances, materials, medicaments, andthe like. It should be noted that these terms are used genericallyherein to describe a variety of fluidal materials that may include, atleast in part, a substance used in the performance of a diagnostic,therapeutic or/and prophylactic medical procedure and such use is notintended to be limiting. It should be understood that the mediumdelivery modulation and/or measurement devices and methods describedherein are not limited to the particular, representative embodiments asdescribed, since variations may be made to these embodiments withoutdeparting from the scope and spirit of the disclosure. Likewise,terminology employed in the description of embodiments is not intendedto be limiting and is used merely for the purpose of conveyance of theconcept. Unless defined otherwise, all technical and scientific termsused herein have the same meaning as commonly understood to one ofordinary skill in the art of which the disclosed devices and methodspertain.

The materials utilized in the manufacture of the monitoring syringe maybe those typical in medical applications. Plastics such as polycarbonatemay be utilized for the syringe housing and plunger. The band orgradation may be printed directly on the plunger shaft, or may beprinted on a discrete plastic sheet or sheath that may then be affixedto the plunger shaft. Various types of printing may be utilized tochange the translucency or opacity of the band or gradation. In someembodiments, the type of printing may be based on the type of light tobe received by the sensors. For example, carbon-based printing may beutilized for sensors that detect infrared light. Thus, the band orgradation may be utilized as the filter described above.

While there have been described herein what are to be consideredexemplary and preferred embodiments of the present technology, othermodifications of the technology will become apparent to those skilled inthe art from the teachings herein. The particular methods of manufactureand geometries disclosed herein are exemplary in nature and are not tobe considered limiting. It is therefore desired to be secured all suchmodifications as fall within the spirit and scope of the technology.Accordingly, what is desired to be secured by Letters Patent is thetechnology as defined and differentiated herein, and all equivalents.

What is claimed is: 1.-26. (canceled)
 27. A method of determining aninjected volume of medium injected into a patient, the methodcomprising: providing a syringe comprising a syringe housing and aplunger slidably disposed in the syringe housing, wherein said syringehousing comprises two elements configured to partially receive twofingers and having a syringe magnet fixed proximate the syringe housing,and wherein the plunger comprises a shaft and a piston, said shaftprovided with at least one syringe Hall sensor and an element configuredto at least partially receive a thumb; providing a diversion reservoircomprising a diversion reservoir magnet and a diversion reservoir Hallsensor; receiving an injection signal from the syringe Hall sensor;receiving an diversion signal from the diversion reservoir Hall sensor;and determining the injected volume of medium based at least in part onthe injection signal and the diversion signal.
 28. The method of claim27, further comprising accumulating the injected volumes of medium anddetermining a total volume of medium injected into the patient.
 29. Themethod of claim 28, further comprising displaying the total volume ofmedium injected into the patient.
 30. The method of claim 29, furthercomprising sending a signal associated with the injected amount ofmedium or the total volume of medium.
 31. The method of claim 30,wherein the signal associated with the injected amount of medium or thetotal volume of medium comprises at least one of an audible signal or avisual signal.
 32. The method of claim 30, wherein the signal is anindication of a maximum injected amount of medium.
 33. The method ofclaim 27, further comprising displaying the injected volume of medium.34. The method of claim 27, further comprising receiving a flush signalassociated with a valve of a saline flush system.
 35. The method ofclaim 34, further comprising disregarding at least one of the injectionsignal and the diversion signal based at least in part on the flushsignal.
 36. The method of claim 35, automatically adjusting a positionof at least one valve based at least in part on the flush signal. 37.The method of claim 27, further comprising disregarding at least one ofthe injection signal and the diversion signal based at least in part ona position of a valve.
 38. A method of determining an injected volume ofa medium injected into a patient, the method comprising: providing asyringe comprising a syringe housing and a plunger slidably disposed inthe syringe housing, said syringe housing comprising two elementsconfigured to partially receive two fingers and having a magnet fixedproximate the syringe housing, and wherein the plunger comprises a shaftand a piston, said shaft provided with at least one Hall sensor and anelement configured to at least partially receive a thumb; receiving afirst injection signal from the at least one Hall sensor resulting froma filling of the syringe housing with a filled volume of medium;receiving a second injection signal from the at least one Hall sensorresulting from an ejection from the syringe housing of an ejected volumeof medium; and determining the injected volume of medium based at leastin part on the first injection signal and the second injection signal.39. The method of claim 38, further comprising accumulating the injectedvolumes of medium and determining a total volume of medium injected intothe patient.
 40. The method of claim 39, further comprising sending asignal associated with the injected volume of medium or the total volumeof medium.
 41. The method of claim 39, further comprising displaying theinjected volume of medium or the total volume of medium.
 42. The methodof claim 40, wherein the signal associated with the injected volume ofmedium or the total volume of medium comprises at least one of anaudible signal or a visual signal.
 43. The method of claim 40, whereinthe signal associated with the injected volume of medium or the totalvolume of medium comprises a signal comprising an indication of amaximum injected volume of medium.
 44. The method of claim 37, furthercomprising receiving a flush signal associated with a valve of a salineflush system.
 45. The method of claim 44, further comprisingdisregarding the injected volume of medium based at least in part on theflush signal.
 46. A method of determining an injected volume of a mediuminjected into a patient, the method comprising: obtaining a syringecomprising a syringe housing and a plunger slidably disposed in thesyringe housing, said syringe housing comprising two finger elementsconfigured to partially receive two fingers and having a magnet fixedproximate the syringe housing, and wherein the plunger comprises a shaftand a piston, said shaft provided with at least one Hall sensor and athumb element configured to at least partially receive a thumb; placingthe two fingers into the two finger elements and placing the thumb intothe thumb element; drawing of the medium into the syringe housing,whereby drawing the medium causes a first injection signal to be sentfrom the at least one Hall sensor; ejecting of the medium from thesyringe housing, whereby ejecting the medium causes a second injectionsignal to be sent from the at least one Hall sensor; and reviewinginformation displayed on a display screen, wherein the informationcomprises the injected volume of medium injected into the patient,wherein the volume of a medium injected into a patient is based at leastin part on the first injection signal and the second injection signal.47. A method of determining an injected volume of medium injected into apatient, the method comprising: fluidly coupling a syringe to a diverterwith a diversion reservoir and a conduit to deliver the medium into thepatient; said syringe comprises a syringe housing and a plunger slidablydisposed in the syringe housing, wherein said syringe housing comprisestwo elements configured to partially receive two fingers and having asyringe magnet fixed proximate the syringe housing, and wherein theplunger comprises a shaft and a piston, said shaft provided with atleast one syringe Hall sensor and an element configured to at leastpartially receive a thumb, and wherein the diversion reservoir comprisesa diversion reservoir magnet and a diversion reservoir Hall sensor;placing the two fingers into the two finger elements and placing thethumb into the thumb element: drawing into the syringe a first volume ofmedium, wherein drawing medium into the syringe causes a first signal tobe emitted from the syringe Hall sensor; ejecting from the syringe asecond volume of medium, wherein ejecting medium from the syringe causesa second signal to be emitted from the syringe Hall sensor and a firstdiversion signal to be emitted from the diversion reservoir Hall sensor;and reviewing information displayed on a display screen, wherein theinformation comprises the injected volume of medium injected into thepatient, and wherein the injected volume of medium injected into thepatient is based at least in part on the first injection signal, thesecond injection signal and the first diversion signal.